This invention relates generally to surgical operating room furniture and equipment and more particularly to apparatus for supporting arthroscopic surgery apparatus.
Arthroscopic surgery requires several pieces of equipment not required for other forms of surgery, including a pressurized saline fluid source, a television camera, a television signal generator, a television monitor, and several other electrical applicances. Heretofore, this equipment has been provided and arranged in the operating room in a rather haphazard fashion. A substantial amount of time is required to set up and take the equipment down each time it is to be used in a different operating room or to allow use of the operating room for a different kind of surgery. Typically, the equipment is arranged on whatever operating room furniture is available without regard to the convenience of use.
It is desirable to position the television monitor so that the surgeon can easily see it while working at the surgical site, but most common surgical furniture provides little flexibility in this regard. It is also desirable to be able to freely position the video camera for viewing the surgical site, but most available operating room equipment is ill-suited for this purpose.
Typically, an intravenous fluid standard is used to support a pair of elevated saline fluid bags. The fluid bags feed fluid via short tubes through a T-connector into a single conduit which is extended to the surgical site. When the bags are nearly empty, the standard must be lowered to change the bags. Lowering the bags reduces the fluid pressure in the conduit, allowing cloudy fluids and blood to enter the surgical site and thereby obsure the surgeon's view until fluid pressure is restored and the obscuring fluids are washed away. This disrupts and slows down the operation. Other drawbacks arise which vary from one arrangement to another of the arthroscopic surgical equipment.
In an attempt to unitize and more conveniently arrange arthroscopic surgical equipment, an arthroscopic surgical support stand has been proposed by Instrument Makar of Okemos, Mich., and is marketed under the brand name THE SURGI-CENTER. This support stand is intended to support in a single unit all of the special purpose apparatus required for arthroscopic-surgery. However, the manner in which such apparatus can be arranged on the stand is less than advantageous and the arrangement of the stand itself creates new problems that are preferably avoided. The stand is a gantry structure comprising two vertically-spaced shelves supported between a pair of wheeled legs. The legs are laterally spaced and the shelves are elongated so that the stand can straddle the operating table. An overhead video boom is connected to the shelves midway between the legs and extends vertically above the shelves for suspending a camera over the operating site. A saline fluid support column is mounted at each lateral end of the stand. In use, the television monitor and other equipment are placed on the shelves and the various wiring and tubing are extended downwardly from the standard to the operating site.
There are various drawbacks to this arrangement. The gantry is generally cumbersome to use and to store and does not support enough equipment. The most serious drawback is that, straddling the operating table and the patient, the stand obstructs access to the patient. Thus, it is not adaptable to surgical operation of joints other than the knee and ankle, such as to shoulders, elbows and hips. In case of an emergency, and upon completion of an operation, the support stand has to be wheeled lengthwise over the table, after detaching any wires and tubes extending down to the patient. In an emergency in which time is of the essence, the time required to disconnect and remove the unit can be critical. Mounting the television monitor on the top shelf of the stand is also a disadvantage, particularly if the surgeon is operating in a seated position. Adjacent electrical equipment can also interfere with operation of the monitor. Equipment positioned on the shelves over the patient is also difficult to reach without reaching across a sterile field and is not protected from saline fluid spills. Nothing in the stand supports surgical instruments conveniently for the surgeon and the gantry structure prevents use of a conventional Mayo tray. One saline fluid support column at a time is used for operating on one side or the other of the patient and the support columns are spaced too far apart to supply fluid to one surgical site from both support columns at the same time.
Outside the field of arthroscopic surgery, a variety of support apparatus or furniture is known, particularly for use in the field of dentistry. Swiss Patent. No. 422,256 discloses a dental cabinet which includes a sub-cabinet of drawers supported on an arm pivotally mounted in the cabinet base for lateral and rotational movement to position the sub-cabinet in easy reach of the dentist. U.S. Pat. No. 3,597,033 discloses a dental console mounted on wheels to facilitate positioning for convenient use by the dentist. U.S. Pat. No. 3,165,367 similarly discloses a wheeled artist's easel. U.S. Pat. Nos. 3,348,799 and 3,530,513 disclose articulated arm assemblies for supporting a dental bowl or dental instrument tray. U.S. Pat. No. 4,138,815 discloses a dental assistance console unit for supporting various dental instruments and a mobile work surface area for easy access by the user. However, none of these patents suggest how to arrange and support arthroscopic surgical equipment so as to overcome the above-described drawbacks of prior arrangements used in arthroscopic surgery.
Accordingly, the need remains for an arthroscopic support stand which overcomes the foregoing drawbacks.